Augmentin Dosing for an 8-Year-Old, 31.8kg Child
For this 8-year-old patient weighing 31.8kg, the recommended Augmentin dose is 45 mg/kg/day of the amoxicillin component divided into 2 doses (approximately 715 mg twice daily) for mild-to-moderate infections, or 90 mg/kg/day divided into 2 doses (approximately 1430 mg twice daily) for severe infections or areas with high pneumococcal resistance. 1
Standard Dosing Algorithm
Mild-to-Moderate Infections:
- Dose: 45 mg/kg/day divided every 12 hours 1
- For this 31.8kg child: 31.8 kg × 45 mg/kg/day = 1431 mg/day total
- Administered as approximately 715 mg twice daily 1
- This provides adequate coverage for most susceptible respiratory pathogens including Streptococcus pneumoniae, non-β-lactamase-producing Haemophilus influenzae, and Streptococcus pyogenes 1
Severe Infections or High-Resistance Scenarios:
- Dose: 90 mg/kg/day divided every 12 hours 1
- For this 31.8kg child: 31.8 kg × 90 mg/kg/day = 2862 mg/day total
- Administered as approximately 1430 mg twice daily 1
- The maximum daily dose should not exceed 4000 mg/day regardless of weight 1
Indication-Specific Considerations
Use the high-dose regimen (90 mg/kg/day) when:
- Community-acquired pneumonia in areas with >10% penicillin-resistant S. pneumoniae 1
- Recent antibiotic exposure within the past 30 days 1
- Child attends daycare 1
- Severe infections requiring hospitalization 1
- β-lactamase-producing organisms suspected (H. influenzae, M. catarrhalis) 1
Use the standard-dose regimen (45 mg/kg/day) for:
- Uncomplicated respiratory tract infections 1
- Skin infections 1
- Genitourinary infections 1
- Acute bacterial sinusitis in children ≥2 years without risk factors 1
Treatment Duration and Monitoring
Standard treatment duration is 7-10 days for most respiratory infections, with pneumonia specifically requiring 10 days 1
Clinical improvement should be evident within 48-72 hours; if no improvement occurs, reevaluation and further investigation are necessary 1
Critical Dosing Pitfalls to Avoid
- Do not exceed 4000 mg/day of the amoxicillin component regardless of calculated weight-based dose 1
- The high-dose formulation (90 mg/kg/day) provides a 14:1 ratio of amoxicillin to clavulanate, which maintains the same daily clavulanate dose while doubling amoxicillin 2
- For β-lactamase-producing organisms, the addition of clavulanate is essential, with eradication rates approaching 100% when the combination is used 1